This is a form to make the reporting of problems consistent, allow records of problems to be kept, and a method of discouraging users from reporting faults in the first place.

Your name? ___________________

Your login name? ____________________

The date? __/__/__

The date the problem first occurred if different? __/__/__

Problem Severity:
Minor__ Minor__
Minor__ Minor__

Which machine? ____________________

Which area appears to be at fault?
Communications__
Disk__
Base Unit__
Network__
Keyboard__
Screen__
Mouse__
Everything__
Don't Know__

Is it plugged in? Yes__ No__

Is it switched on? Yes__ No__

Has it been stolen? Yes__ No__

Have you tried to fix it yourself? Yes__ No__

Have you made it worse? Yes__

Have you read the manual? Yes__ No__

Are you sure you've read the manual? Yes__ No__

Are you absolutely certain you've read the manual? Yes__ No__

Did you understand it? Yes__ No__

If `Yes' then why can't you fix it yourself? _____________________________________________________________

Is the equipment unexpectedly noisy? Yes__ No__

If `Yes' what sort of noise? Grinding__
Rattling__
Whirring__
High pitched whine__
Sound of disk head scouring disk__
Strange, out of tune whistling or humming__

Is there a smell of burning? Yes__ No__

If `Yes' is the equipment on fire? Yes__ No__

Is the fault repeatable? Yes__ No__

What were you doing (with the equipment) at the time the fault occurred? ______________________________________________________

If `nothing' explain why you were logged in. _______________________________________________________________

Are you sure you aren't imagining the problem? Yes__ No__

Do you have any independent witnesses of the problem? Yes__ No__

Describe the problem. _______________________________________________________________

Now, describe the problem accurately. _______________________________________________________________

Speculate wildly about the cause of the problem. _______________________________________________________________ _______________________________________________________________

Can't you do something else, rather than bothering me? Yes__ No__